A Special Invitation for Alliance Teachers

By completing this form, you are opting into being part of the first group of educators to join the new digital National Geographic Educator Community, set to launch in 2017. Your information will be securely stored in our database, and you will get a special invitation once the community is launched. Your information will not be shared, and you will not receive communication from us outside of the community invitation unless you opt into receiving additional information listed at the end of this form. 

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* 1. First Name

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* 2. Middle Name

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* 3. Last Name

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* 4. Suffix

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* 5. Birthdate - Please list as Month/Date/Year (00/00/0000)

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* 6. Gender

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* 7. Preferred Email Address

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* 8. Primary Mailing Address Line 1

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* 9. Primary Mailing Address Line 2

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* 10. City

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* 11. State/Province

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* 12. Zip Code

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* 13. Name of School or Organization

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* 14. Type of School

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* 15. Primary Role

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* 16. Subjects You Teach

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* 17. Grade Levels You Teach

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* 18. # of Years Teaching

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* 19. Year You Joined Your Alliance

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* 20. Are you a Nat Geo Certified Educator?

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* 21. Would you like to receive further communication from National Geographic? Please select all that apply.

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